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Driving with diabetes

Diabetes can affect you in ways that you might not suspect—including how you drive a car.

While most people with diabetes drive safely—and pose no threat either to themselves or others—complications of the disease can interfere with the ability to operate a vehicle. A key complication is low blood sugar, or what doctors call hypoglycemia.

Everyone with diabetes gets low blood sugar from time to time. It is often triggered by not eating enough food or by taking too much insulin or too many diabetes pills.

Low blood sugar can cause confusion and make it hard for you to focus on traffic or control your car. It can also cause light-headedness, blurry vision and other problems that can transform a typically safe driver into a dangerous one.

6 rules of the road for people with diabetes

Because low blood sugar can make driving so risky, it's important to follow these precautions advised by the American Diabetes Association and the National Highway Traffic Safety Administration.

1. Test yourself. If you frequently have low blood sugar, check your blood sugar before driving.

2. Don't take chances. Never drive with low blood sugar, even if that means you'll arrive late. If your blood sugar is low, eat a snack with a quick-acting source of sugar, such as juice, a nondiet soda, hard candy or glucose tablets. Wait 15 minutes, then check your blood sugar again to be sure it's in your target range before you drive.

3. Don't get caught on empty. Stock your car with healthy, nonperishable snacks and fast-acting sugars. And always travel with your blood glucose meter.

4. Learn your early warning signs. Many people with diabetes experience physical or emotional changes when blood sugar becomes low. Symptoms vary from person to person but may include paleness, shakiness, sweatiness, irritability, a dry mouth, sleepiness and confusion. Recognizing early warning signs is vital. Left untreated, low blood sugar can make you pass out.

If you experience low blood sugar without warning signs, stop driving entirely. Talk to your doctor about blood glucose awareness training, which may help you learn to recognize the beginning stages of low blood sugar.

5. Pull over right away if you have symptoms. Stop driving immediately if you have any warning signs of low blood sugar. Then test your blood sugar to see if it's actually low. If so, treat it and don't resume driving until it is back to normal.

6. Let your doctor know how you're doing. In particular, alert your doctor if you have an episode of severe low blood sugar that requires a glucagon injection. Severe means blood sugar so low that you are too confused or impaired to treat yourself with a fast-acting sugar and another person must help you. Your diabetes might be affecting your ability to drive, and your doctor may be able to suggest steps that can keep you safe behind the wheel.

How else can diabetes affect my driving?

Other complications of diabetes—such as vision problems, a loss of sensation in your feet or an amputation—can also affect your driving. Be sure to discuss these with your doctor, too, if they apply to you.

Everyone with diabetes should get regular eye exams to check for diabetes-related eye problems that could affect your ability to drive.

Your doctor can refer you to a driving specialist, who can give you on- and off-road tests to see if—and how—diabetes complications are harming your driving. If your driving has suffered, the specialist may also be able to help you improve it.

Remember: When it comes to driving—and protecting yourself and others—you can never be too safe.

Reviewed 4/5/2023

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